NICOLE HOLMBERG PH.D.
NPI 1922654375
Psychologist - Clinical in Des Moines, IA

Q: What is Nicole Holmberg's NPI number?

The NPI number for Nicole Holmberg is 1922654375. It was assigned to this individual provider in the NPPES registry on August 12, 2019.

Q: What is Nicole Holmberg's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Nicole Holmberg enrolled in Medicare?

No. Nicole Holmberg has opted out of Medicare through January 29, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Nicole Holmberg was last updated on February 28, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 12, 2019Opted out of Medicare · through Jan 29, 2028

3209 INGERSOLL AVE STE 100, DES MOINES, IA 50312(515) 444-0480 Get Directions Write a Review

NPPES record last updated: February 28, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 28, 2022, Jul 30, 2021, Aug 12, 2019 (3 updates tracked since 2019).

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About Nicole Holmberg Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE HOLMBERG PH.D. (NPI 1922654375) is an individual clinical provider in Des Moines, Iowa, licensed in Iowa (097600) and active in the NPI registry since August 2019. She has opted out of Medicare through January 29, 2028.

NPPES Registry Identity

NPI1922654375

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameNICOLE HOLMBERGCredential: PH.D.

Location Address3209 INGERSOLL AVE STE 100Des Moines, IA 50312-3920

Mailing Address3209 Ingersoll Ave Ste 100Des Moines, IA 50312-3920 · (515) 444-0480

Phone(515) 444-0480

Sole ProprietorYes

Enumeration DateAugust 12, 2019

Last NPPES UpdateFebruary 28, 20223 updates tracked since enumeration

NPPES CertifiedFebruary 28, 2022

✔ NPI 1922654375 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in IA · 097600

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

3209 INGERSOLL AVE STE 100, Des Moines, IA 50312

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Nicole Holmberg Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 29, 2024 through January 29, 2028.

Opt-Out Effective DateJanuary 29, 2024

Opt-Out In Effect ThroughJanuary 29, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MARIAH ANDREASEN LMHC, NCC

Counselor (Mental Health)